Fireball Run 2005 Official Entry Form

2005-05-09 14:51

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It is extremely important to bear in mind that all 'Competition Bookings' are to be taken on a first come, first served basis. Once the race field quantities of 50 cars and 50 motorcycles have been filled, we will automatically close the book.

The entry fees are as stipulated in the 'Official Rules and Regulations' booklet.

A forty percent (40%) non-refundable deposit is to accompany your entry form, with which to secure your entry and number. The balance of the payment will be required by no later, than the last working day in August 2005. This date will ensure that, should you no longer wish to participate, the 'Organising Committee' has sufficient time in which to fill the void. Deposits are to be paid directly to our attorneys, and into the following 'Trust' account:

Cranko Karp & Associates Inc.

Trust Account.

Nedbank,

Kruis Street.

Branch Code: 190605.

Account No.: 1906316465.

Please ensure that when lodging your deposit, whether physically or electronically, you state the reference as 'FR' followed by your name. This will help facilitate the administration of the funds. Our legal representative is Mr Paul Carbonari. NB. Unless your deposit has been paid into the account, we will not consider your application as valid. Once all the 50 cars and 50 motorcycle spots (with deposits) have been filled, we will close the bookings, and no additional entries will be entertained. Proof of payment must be faxed through to 011 643 3816, and marked for the attention of 'Maggie'.

Included in the entry fee are the following:

Hotel accommodation (City Lodge type accommodation) at each destination, based on a room sharing if you bring a passenger along.

Secure overnight parking.

Breakfast each day.

A picnic basket (Munchies) filled with catering and beverages for each days run.

All evening meals with wine & mineral waters (not unlimited), at the Gala theme evenings at various casinos. Thereafter it is a 'Cash Bar'.

VIP entrance to party nights.

Fully detailed route books compiled from the pre-driven selected routes, and produced by VeZA.

Official Fireball Run 2005 car decals and door numbers for your car or bike.

Participation at all National race circuits throughout the route.

A shot at the title, trophy and free entry into next years' event, for the fastest overall contestant, in both, cars as well as bikes.

Final night gala and awards ceremony.

Special souvenir gifts for all Fireball Run 2005 participants.

Random awards, in the form of medals each day of the contest, for various categories.

Fully equipped ICU Ambulance units, throughout the run. One in front of the pack, and one behind.

Fully equipped rescue and life support units. One in front of the pack, and one behind.

Road freighting of all luggage between race points and destinations. This does not include the arrival or departure from the event, but is merely there to assist the crews, and lessen their daily burdens during the actual event.

Services of the Fireball Run 2005 Organising Committee Event Managers, Checkpoint Crews, Photographers and Film Crews.

Participation of all Provincial Traffic Departments, Traffic Officers, SAPS Officers, and the Department of Transport.

The above fee will not include the following:

Petrol, oil, tyres, and racing car / bike repairs.

Toll payments.

Personal and racing car / bike insurances.

Insurances and Medical insurance.

Incidental expenses.

The passenger / Navigator need only fill in their personal effects, and not repeat the vehicle specifications. This pertains to the cars only.

The driver entering the event, is not required to submit the details of their passenger at this stage of planning, but will be requested to provide these details by no later than the end of August 2005.

The sharing of hotel rooms is imperative, unless prior arrangements and additional bookings have been made. We have negotiating extremely favourable rates. Additional rooms will be for the account of the person booking the extra room.

Please refer to the 'Rules and Regulations' booklet, which is an ongoing 'work-in-progress' exercise, and will be continually improved, subtracted from, added to, and amended during the years to come.

Classes are as stated in the 'Rules and Regulation' booklet. These rules are posted here

Please complete the following:

Team Profile.

Team Name:

Sponsor (Corporate branding).

Driver / Rider.

Nickname:

Full Name:

Male / Female:

Identity Number:

Occupation:

Residential Address:

Postal Address:

Home Telephone (+Code):

Business Telephone (+Code):

Mobile Number:

E-mail Address:

Drivers Licence Number

(Proof of validity will be required before setting off on the event):

Do you have any Previous Skidpan or High Speed Racing Experience?

Insurance Policy Details:

Medical Aid Details:

Medical History and General Health:

Blood Group:

Allergies:

Religious Cuisine Preferences:

Closest Relative Details in the Case of Emergency.

Full Name:

Residential Address.

Contact Telephone Number, or Numbers:

Navigator (Cars only).

Nickname.

Full Name.

Male / Female.

Identity Number.

Occupation.

Residential Address.

Postal Address.

Home Telephone (+Code).

Business Telephone (+Code).

Mobile Number.

E-mail Address.

Drivers Licence Number

(Proof of validity will be required

before setting off on the event).

Competition Licence Details.

Do you have any Previous Skidpan or High Speed Racing Experience?

Insurance Policy Details.

Medical Aid Details.

Medical History and General Health.

Blood Group.

Allergies.

Religious Cuisine Preferences:

Closest Relative Details in the Case of Emergency.

First Name.

Surname.

Contact Telephone Number, or Numbers.

Race Car / Bike Details

(Only to be filled in by the Driver / Owner). A lot of this information will be used to determine the class in which a car / bike is entered into, and the balance will be used on the website for the interest of spectators.

Race Car / Bike Make.

Race Car / Bike Model.

Engine Capacity.

Number of Cylinders.

Configuration (Flat, V, or straight).

Number of Valves per Cylinder.

Mass of Race Vehicle.

Fuel Intake System

(i.e. Carburettor, Fuel Injection, or fuel induction systems such as Turbo or Supercharged).

Fuel being used.

BHP / kW developed.

Gearbox (Type and number of forward gears).

Braking System.

Running Height (Standard or lowered)

Shock Absorbers (Standard or modified).

Tyre Size and Make - Front.

Tyre Size and Make - Back.

Road Legal Registration Number of Car / Bike.

We have read all pages of this 'Official Entry Form', and solemnly swear that we understand the content herein, and have completed the questionnaire to the best of our ability and informed knowledge. We have also read the 'Rules and Regulation' booklet as published by the organisers of the 'Fireball Run 2005', and understand and agree to abide by the content thereof. We undertake and agree to consciously and diligently complete all 'Indemnity' forms presented by the race organisers and race circuits. We undertake to obey all the traffic laws, as well as the 'Rule and Regulations', which govern the National and Municipal roads of the Republic of South Africa.

New dates have been set for the 2005 Fireball Run, the only national promotional touring racing and exhibition event available to the automotive and motorcycle sector in South Africa, as well as the general public.

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